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32C-122 (2) ILE"L ___ NoTicE ,)„. ,,,,.,,k, 4 ?..a, e:, ::„... 44 r. e,-4v, Date /g --p7©f Article j 6 7i( , Section of t Wing Ordinance REAS,violations of Article R - , Section te Building Code have been found on Article , Section of the. Code premises, IT IS HEREBY ORDERED in accordance with the above Code that all persons cease, desist 1, and STOP WORK at once pertaining to co truction, alterations or repairs on these premises known as (9 £ F i tr U 1 T 7 persons acting contrary to this order or removing or mutilating this notice are liable to arrest ;ss such action is authorized by the Department. / ' BUI • NG OFFICIAL 4 + e 1 �a �xtg 7EtxIr£ lJxt —__=*---_v, f $ � 1 '°r a=�s :ice 1�• gasatic nsctts ""°� DEPARTMENT OP BUILDING INSPECTIONS 212 Main Street ' Municipal Building —=_ Northampton, Mass. 01060 '" r' WORKER'S D2 / s /COMPENSAT[ON INSURANCE; A1�1�U)AVIT L Marx e Oi censeelpermi ttee) with a principal place of business/residence at: • • `/om--1e ire ice,s14°4',010,1 /1a.. 0/02 ) (phone#) 01 7—/ 77( (str tcity/stalr/aP) do hereby certify, under the pains and penalties of penury, that: lly1 am an employer providing the following worker's compensation coverage for my employees working worl6ng on this job: --( bi.rJ'y �'i'%1ftic. ) i.cr 3'r3/ 7/49 oo - (Insurance Company) (Policy Number) (Expiration Date) ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additiocal shod if necessary to include information pertaining to all contractors) ( ) I am a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE:pleat,-be aware that while homeowners who employ persons to do maintenance,wester Of repair work on a dwelling of not more than three units in which the homeowner resides or on the grounds appurtenant thereto are not generally noasidcred to be employers under the worker's co¢ipeusation Act(GL152,ss 1(5)),application by a homeowner for a Game or permit may evidence the legal stone of an employer under the Worker's Compensation Act I understand that a copy of this ctatcmrni may be forwarded to the Depertumt of Industrial AccickatY Office of Lciauraoce for the coverage verification and that failure to secure coverage under section 25A of MOL 152 can lead to the imposition of criminal penalties consisting of aline of up to S 1,500.00 andfor*Iris' mprisonment of up to one year and civil penalties in the form of a Stop Work Order and a fin,0(5100.00 a day against mc. For dcp+tTrrstnl woo Daly Permit Number Map# L of;9 Signature of Liccnsee/Permitfee Date r. ti • SSECTON Z CONSTRUCTION SERVICES l 8.1. Licensed Construction Suypye�rvisor:: Not Applicable ❑ Name of License Holder: 1 ' c- `C ' je I is- l - d 7 7 33 L/ License Number 3 Rfair/,f— f A-1 - ,1 /7?CI, � _ / Address ‘./ „. Expiration Date 7% /�—, S)- -7 ci 77 5- Signature Telephone :FRe 'terei`�n' 1T r evi1len 7 n r _ Ti. x~� ' aiaria: 7;tie i: _ C ©0 l r,, Not Applicable ❑ i2 la a 3 S Company Name Registration Number ito gle, /9-e _.J v�' I- to r-) c G -c-.5a Address Expiration Date Telephone � 7 -I 7 7 c SECTION 10-WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c. 152, § 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this attic will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes ❑ No ❑ .7, 0 ni elOwner e III tt,e,n:: The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)famili and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner act as supervisor. CMR 780, Sixth Edition Section 108.3.5.1. Definition of Homeowner: Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered p homeowner. Such"homeowner"shall submit to the Building Official, on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152(Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated, you may be liable for person, you hire to perform work for you under this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature r• 1SECTION5 D SCRIPTIO OFPROPOSED WORK[check alIvapplicable) 9 or. 1;$SQ,40 0,vf.5:_AnT>L,^G„ -. n? „ New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ler Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ 1 Decks [ ] Siding[ ] Other [ Brief Description of Proposed Work: Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative❑ Renovating unfinished basement Yes No Plans Attached Roll ❑- Sheet❑ Ga If New ouse an"cl®r dtlrtiiAiAb stingzhousing,,cdr p 1 etelth el diI69.ing: a. Use of building : One Family Two Family Other_ b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Mascheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft. of wetlands? Yes _ No. Is construction within 100 yr. floodplain Yes j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No . I. Septic Tank City Sewer Private well City water Supply SECTION 7a,-OWNER:AUTHORIZATION -TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES f OR3BUILOING PERMIT , as Owner of the subject prope hereby authorize tc ac my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date , as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and pen (ties of perjury. Print Name �" Signature of Owner/Agent Date Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN DENIED DUE TO LACK OF INFORMATION Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO . DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW YES IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained , Date Issued: C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ?YES No IF YES, describe size, type and location: 1 • M, H; 1 L. `" ity'of Northampton ' building Department H ? ^ r__7 i ' 212 Main Street Room 100 1 i _J No thampton, MA 01060 I_._.. < ` �.`F ; 413 587.1240 Fax 413.587-1272 �---- � APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION'1-SITE INFORMATION This section to1be completedibyoffice 1.1 Property Address: /jL /T/ x � � !� �V Map L'ot Unit Zone, Overlay�0isttict Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: MM i l�faf �U ) c So* GO /.27 ,C/Qrence ,n9 . Name(Print) Ctrrent Mailing Telephone Signature 2.2 Authorized Agent: / /11c k �et‘ Sie ) o c3X 30G k--1; h�w�po„ ' Name(Print) Culrent Mailing Address: Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6), 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) - a 0 Check Number / This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/inspector of Buildings Date 4. ; MAT ST BP-2002-0608 GIS#: k COMMONWEALTH OF MASSACHUSETTS Map:Block 32C 122 . , CITY OF NORTHAMPTON Lot: -001 Permit: Building Category:roofing BUILDING PERMIT Permit# BP-2002-0608 Project# JS-2002-0945 Est. Cost: $7200.00 Fee: $100.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: RCI ROOFING 126235 Lot Size(sq. ft.): 5401.44 Owner: MOGGIO MARK A Zoning: URC Applicant: RCI ROOFING AT: 26 FRUIT ST Applicant Address: Phone: Insurance: P O BOX 309 (413) 527-4775 Workers Compensation EASTHAMPTONMAO1027-0309 ISSUED ON:12/27/01 0:00:00 TO PERFORM THE FOLLOWING WORK:STR 1 P & SHINGLE ROOF POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 12/27/01 0:00:00 MO $100.00 212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo